Bar News - April 20, 2007
Book Review: "Anatomy for Litigators"
By: Book Review by Holly B. Haines
"Anatomy for Litigators"
By Samuel D. Hodge, Jr.
The title of this book is misleading. The book should be called, Anatomy for Defense Attorneys, because almost every chapter ends with litigation tips for defense attorneys to defeat causation in personal injury, worker’s compensation and disability claims. Overall, however, this book is a very useful, solid primer on limited areas of human anatomy, and I would highly recommend it to any younger lawyer beginning a career in personal injury, worker’s compensation, social security, or insurance defense work, or to more experienced litigators seeking a quick refresher on limited aspects of human anatomy, a litigation checklist, or a jury verdict analysis of specific personal injury claims.
The author, Samuel D. Hodge, Jr., is a law professor at Temple University and an experienced trial attorney in Philadelphia. Hodge says that he wrote this book for attorneys who want to understand the basics of human anatomy and to help attorneys understand the medico-legal issues involved in personal injury claims. He achieves these purposes in his book, but the scope of the book is limited to the most commonly injured areas of the body and the most common personal injury claims. Anyone involved in more complex personal injury litigation or medical malpractice cases would be better served by referring to more authoritative anatomy texts or educational medical texts in the specialty area in which an injury claim resides.
The beginning and ending chapters of the book are the most useful to all practitioners, as they provide the most litigation tips for pursuing and defending injury claims. The book begins with a solid overview of human anatomy, summarizing all of the systems of the human body and providing interesting historical anecdotes. There are hundreds of illustrations, most of which are very simple and drawn in pen and ink, that are useful for learning the parts of the body, but that would not be particularly impressive to use when you are standing alone in front of a jury.
Hodge also provides a very simple, plainly written lesson on how to request, organize and interpret medical records. He aptly recognizes the irony between the difficulties inherent in obtaining and interpreting medical records and the regulations that mandate that medical records be created and maintained whenever a patient receives treatment. He discusses the non-uniformity of medical provider record-keeping, abbreviations, handwritten comments and diagnostic codes, and provides tips on how to organize and interpret the records. Hodge also provides tips on how to decipher ICD codes and health insurance billing statements to determine what treatments a patient has actually received. He further analyzes the different motivations and reasons that plaintiff and defense counsel need medical records and what each counsel should seek within the framework of the records they receive. Finally, he discusses the different preexisting conditions that can be discovered with a careful analysis of pharmacy and medical records—or, an analysis of how defense attorneys can defeat or discount a plaintiff’s claim.
In addition to the helpful hints he provides for reading medical records, Hodge discusses the different types of investigation that counsel should conduct into the background of each treating physician. He briefly touches on licensing and credentialing issues, and provides Web sites to aid counsel in their investigations. He further provides basic, but non-authoritative, Internet references and tips on how to conduct medical research for personal injury claims and how to find illustrations and trial exhibits for use in prosecuting or defending such claims. Unfortunately, he does not put these highly recommended illustrations in his book.
The author provides a very useful primer on the different types of diagnostic imaging and their limitations, and his defense bias radiates throughout this discussion. He actually seems to advocate for less diagnostic testing of patients who present for medical treatment after a traumatic injury because “the taking of an x-ray only encourages the patient’s belief that he or she is not well.” He opines that abnormal findings on films are not usually clinically significant and provides several limited population studies to support this assertion. He further discusses “what x-rays can tell the defense” and provides a survey of different legal challenges to the tests and their result validity.
Despite the glaring defense bias, this section on diagnostic imaging does provide an overview of almost all different types of diagnostic tests, their purposes and uses, and when they are indicated. It is a useful reference to any attorney who seeks a concise explanation of the different nuclear scans and tests available and their limitations.
The remainder of the book is a solid anatomy primer, but its primary focus is on fractures, sprains and strains more than on serious medical conditions. The author acknowledges that the focus of the book is on the most common workplace injuries, personal injuries from falls and injuries from motor vehicle accidents. The anatomy lessons provided are on the bones, the back, the chest, the shoulder, the hand, the hip, the knee, the ankle, the foot, and the tooth—the last a chapter that seemed very out-of-place and written solely because it is an academic legal interest of the author or a focus of his practice for claims he defends.
Each chapter explains how to use a claimant’s risk factors or preexisting medical conditions to defeat causation or discount the severity of the injury claimed. In addition to the defense tips provided, there are numerous non-authoritative references and Web sites for further information, case examples, and a brief analysis of jury verdicts and settlements for each type of injury to the body part being discussed.
The most interesting chapters in the book are those at the end that discuss the independent medical examination (IME), which the author acknowledges is colloquially called “the defense physical.” Hodge provides a detailed explanation of how attorneys should determine when an IME is really necessary and he analyzes the legal considerations that are involved whenever an IME occurs. He notes that while an IME is a good snapshot of the plaintiff’s condition at a moment in time and is very useful to objectively discount a plaintiff’s subjective complaints, it can also be a snapshot that ends up substantiating all of the plaintiff’s claims or enhancing injuries that are benignly described in the medical records.
The book ends with a detailed verbal and pictorial orthopedic IME exam, including all of the questions that must be asked and all of the tests that must be performed for the exam to be completed. This chapter is particularly useful to a plaintiff’s counsel who videotapes or attends an IME to ensure that all tests are administered correctly and that all appropriate information is gathered to ensure an “independent” examination result.
All-in-all, this is a solid, but non-authoritative, anatomy book with useful tips for young litigators or for more experienced litigators with a general practice who do not exclusively practice in the injury and disability arena. While the book is definitely biased and focused on how to defend against injury and disability claims, this focus is actually useful for plaintiffs’ lawyers to review so they can prepare their cases with the defense perspective at the forefront of their minds. Experienced practitioners or practitioners who deal with more complex injury claims will likely be very disappointed with this book, as it is limited in both scope and application, but it would be a great book to give to a young associate beginning practice to allow him or her to hit the ground running with a personal injury career.
Holly B. Haines is an attorney with Abramson, Brown & Dugan in Manchester. She is chair of the NH Bar News editorial advisory board and has been a member of the NH Bar since 2000.